Cost comparison of UniAMP with Truenat for tuberculosis detection in India

BACKGROUND: The molecular platforms such as Truenat and GeneXpert have enhanced tuberculosis (TB) diagnostic capacity in India. However, these technologies still face challenges related to cost, infrastructure requirements and maintenance. To address these gaps, several newer molecular diagnostic tools are emerging, including UniAMP. However, the cost implications and economic feasibility remain limited in Indian context. We conducted cost comparison of UniAMP with Truenat for TB detection in India. METHODS: A decision tree model was developed from a health system perspective to compare UniAMP with Truenat for TB detection. Sensitivity and specificity data were collected from published literature and validation reports. Diagnostic outcomes such as true positives and negatives were estimated for the cohort of 1,000 presumptive TB patients. Costs data were collected from ICMR-NIRT laboratory and average cost per test and per case detection was estimated. The comparison was done between UniAMP and Truenat. RESULTS: The estimated per test cost was ₹483 (US$5.54) for UniAMP and ₹834 (US$9.57) for Truenat. Case detection in a cohort of 1,000 presumptive TB, true positive was 265 and 296; true negatives 647 and 651 in UniAMP and Truenat respectively. UniAMP identified fewer true positive TB cases than Truenat (265 vs 296), resulting in 31 (10.7%) reduction in diagnostic yield. CONCLUSIONS: UniAMP may support decentralised TB testing in resource limited settings because of its lower cost and minimal infrastructure requirements. UniAMP may therefore be more suitable as a supplementary diagnostic option rather than a replacement for established molecular tests such as Truenat.